Passive surveillance assesses compliance with COVID-19 behavioral restrictions in a rural US county

Christina L. Faust, Brian Lambert, Cale Kochenour, Anthony C. Robinson, Nita Bharti

Research output: Contribution to journalArticlepeer-review


Following the emergence of SARS-CoV-2, early outbreak response relied on behavioral interventions. In the United States, local governments implemented restrictions aimed at reducing movements and contacts to limit viral transmission. In Pennsylvania, restrictions closed schools and businesses in the spring of 2020 and interventions eased later through the summer. Here we use passive monitoring of vehicular traffic volume and mobile device derived visits to points of interest as proxies for movements and contacts in a rural Pennsylvania county. Rural areas have limited health care resources, which magnifies the importance of disease prevention. These data show the lowest levels of movement occurred during the strictest phase of restrictions, indicating high levels of compliance with behavioral intervention. We find that increases in movement correlated with increases in reported SARS-CoV-2 cases 9 to 18 days later. The methodology used in this study can be adapted to inform outbreak management strategies for other locations and future outbreaks that use behavioral interventions to reduce pathogen transmission.

Original languageEnglish (US)
JournalEpidemiology and Infection
StateAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Infectious Diseases

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